This qualitative study sought to explore the unique experiences of children receiving hematopoietic stem cell transplant (HCT) and their caregivers, with a primary focus on the multifaceted aspects of adherence following discharge.

Convenience sampling was used to enroll 14 caregivers and 15 children at a large Midwestern children’s hospital. Children had an allogenic HCT for a malignant or nonmalignant disorder and were 1–12 months off immunosuppression. Participants completed a semi-structured interview in the HCT-clinic or via phone about the child’s experience taking medications and adhering to post-transplant guidelines.

Caregivers were primarily female (n = 13, 87%), White (n = 11, 73%), and not Hispanic (n = 15, 100%). Children were primarily male (n = 9, 60%), White (n = 10, 67%; missing: n = 3), and not Hispanic (n = 13, 87%; missing: n = 2). Children’s average age was 13.14 years (SD = 2.88). Two primary themes emerged from the interviews, (1) family navigation and self-management of post-HCT medications and restrictions with 3 subthemes highlighting structured routines, adaptations to life post-HCT, and experiences with daily restrictions and other aspects of care; (2) advice from families on navigating post-HCT care with 2 subthemes highlighting communication and strategies for maneuvering post-HCT treatment. Of note, half of caregivers (n = 7, 50%) reported the child was responsible for taking their medications, and 43% (n = 6) of children were responsible for knowing when to take their medications.

This study contributes a nuanced understanding of adherence in pediatric HCT, emphasizing the need for tailored interventions that transcend traditional medical frameworks and enable clear communication between families and the medical team. Findings underscore the importance of providers adopting a comprehensive and patient-centered approach. Healthcare providers should consider the psychosocial aspects of HCT, implement tailored family-centered strategies to optimize adherence, and prioritize comprehensive communication to improve outcomes.

Prolonged grief disorder (PGD) is a debilitating condition recently recognized to psychiatric diagnostic manuals. There is a pressing need for valid, reliable, and culturally adapted instruments that align with internationally established diagnostic criteria for the diagnosis of pathological grief, particularly for Latinx populations, who often face limited access to timely mental health services. This study aimed to translate, adapt, and validate the Mexican version of the PG-13-R scale.

We translated and then back-translated the original PG-13-R. The scale was reviewed by experts in psychometrics and cognitively debriefed with a Mexican sample. The study included 397 participants, consisting of: (1) Family members of patients who died from cancer and received supportive care from a patient navigation program at a public hospital in Mexico City (CDMX) and (2) Individuals from the broader community who were contacted via social media (X, Facebook). Participants completed an online survey that included sociodemographic data, the preliminary version of the PG-13-R, an assessment of depression (PHQ-9) and of anxiety (GAD-7). Internal consistency was analyzed using Cronbach’s alpha. A confirmatory factor analysis (CFA) was conducted to examine evidence of validity, along with a Pearson correlation analysis between PG-13-R scores and existing measures assessing related but distinct constructs (i.e., depression and anxiety).

CFA supported a 1-factor structure with good model fit after accounting for error covariance between related items. The Mexican PG-13-R demonstrated good internal consistency (Cronbach’s α = 0.89) and positive significant correlations with measures of depression and anxiety, providing evidence of score reliability and validity.

The adapted PG-13-R offers a culturally appropriate tool for assessing prolonged grief in Mexican Spanish-speaking populations, with potential for use in clinical and research settings. The use of the PG-13-R scale is recommended for clinical research and mental health care in the Mexican population.

Palliative and end-of-life (EOL) care is gaining increasing importance in Saudi Arabia due to the rising burden of chronic and life-limiting illnesses. Nurses play a central role in delivering comprehensive, culturally appropriate palliative care; however, their practices are influenced by educational preparation, institutional support, and sociocultural and religious contexts. To date, evidence on palliative nursing care in Saudi Arabia remains fragmented and insufficiently synthesized.

This systematic review aimed to synthesize existing evidence on palliative and EOL nursing care in Saudi Arabia, with a focus on nursing practices, challenges, cultural and spiritual influences, and patient and family outcomes.

A systematic literature search was conducted in January 2025 using PubMed, Scopus, CINAHL, Web of Science, Google Scholar, and Saudi grey literature sources. Empirical qualitative, quantitative, and mixed-methods studies addressing palliative or EOL nursing care in Saudi Arabia were included. Study selection followed PRISMA guidelines, and methodological quality was appraised using appropriate critical appraisal tools. A narrative thematic synthesis was undertaken due to heterogeneity among studies.

Fourteen studies met the inclusion criteria. Findings indicated that nurses are actively involved in symptom management, therapeutic communication, psychosocial support, spiritual care, and family-centered care. However, substantial barriers were identified, including gaps in knowledge and training, limited formal palliative education, emotional burden, ethical challenges related to nondisclosure, and inconsistent institutional policies. Cultural and religious norms strongly influenced communication practices and decision-making processes. Studies also showed that structured palliative care services, particularly home-based and multidisciplinary programs, were associated with improved patient comfort, dignity, and family satisfaction, although access to such services varied across regions.

Palliative and EOL nursing care in Saudi Arabia demonstrates commitment and potential but is constrained by educational, emotional, cultural, and systemic challenges. Strengthening nursing education, enhancing culturally sensitive communication and spiritual care training, expanding home-based palliative services, and providing institutional support for nurses’ emotional well-being are essential to improving the quality and equity of palliative care nationwide.

This study examined how repeated exposure to trauma narratives influences professional quality of life, including burnout, secondary traumatic stress (STS), and compassion satisfaction (CS), among end-of-life healthcare providers. The moderating roles of resilience and both organizational and personal support were also tested.

A cross-sectional online survey was completed by 507 healthcare providers working in hospice, oncology, or other end-of-life settings. Participants completed validated self-report measures assessing exposure to trauma narratives (Vicarious Trauma Scale [VTS]), professional quality of life (ProQOL-5), resilience (STARS-6), organizational support (SPOS), and social support (MSPSS). Hierarchical regression and moderation analyses were conducted to evaluate main and interaction effects.

Greater exposure to trauma narratives was significantly associated with higher burnout (β = .37, p < .001) and STS (β = .42, p < .001), and with lower CS (β = −.13, p = .004). Higher resilience and organizational support predicted greater CS and lower burnout and STS. A significant VTS × resilience interaction indicated that resilience buffered the association between exposure to trauma narratives and STS (β = −.10, p = .009).

Repeated exposure to trauma narratives is a meaningful occupational stressor for end-of-life clinicians. Resilience and organizational support appear to protect against the negative impact of trauma exposure and promote CS, highlighting key multilevel targets for trauma-informed workforce interventions.

This study addresses a critical gap by clarifying how repeated trauma narratives specifically influence burnout, Secondary Traumatic Stress (STS), and Compassion Satisfaction (CS) within the unique context of end-of-life care. The results provide a nuanced framework for understanding how clinicians maintain empathic presence despite chronic emotional demands. Furthermore, by identifying specific resilience factors and support systems that buffer against psychological distress, these findings offer actionable insights for developing targeted interventions to mitigate long-term professional harm.

Narrative-based approaches have been utilized in medicine to better understand the illness experiences of individuals living with chronic conditions. In particular, people with amyotrophic lateral sclerosis (pALS) may benefit from use of narrative-based approaches, given the potential impact of progressive decline on identity of self. This review explores the use of narrative-based approaches in studies involving pALS to provide further insight to the experiences and psychosocial needs of this population.

A search was conducted utilizing EMBASE, CINAHL, PsycInfo, and Google Scholar with several terms related to amyotrophic lateral sclerosis (ALS) and narrative-based approaches. Studies were included if they were written in English, incorporated methods that promoted the production of narratives, and reported data that could be clearly isolated to pALS.

The search revealed a total of 154 articles for title and abstract screening. Fifty-two articles were selected for full-text review. Thirty-two articles met the criteria for data extraction. Four descriptive categories emerged upon examination of the narrative-based approaches implemented across the studies: psychosocial intervention, illness experience, intervention targeting specific needs, and secondary analysis of data. Some of the common themes identified across studies included: loss of physical and communicative function, adaptation to life changes, shifts in identity, and tension with the healthcare system.

Despite the communication challenges that often coincide with disease progression, narrative-based approaches can be utilized in pALS. These approaches should be implemented to gain insight on the disease experiences of pALS, providing opportunity for patient-centered interventions to address the psychosocial needs of this population.

Although patients with lung cancer are at high risk of poor outcomes from COVID-19, little is known about the economic and psychosocial impact of the pandemic on this population. This study had 2 objectives: (1) to identify the prevalence of financial and social disruptions and other adverse COVID-19 experiences in socioeconomically diverse patients with lung cancer; and (2) to examine whether these experiences were associated with physical and psychological symptoms.

Patients with lung cancer (N = 191) were recruited from a cancer center in the midwestern U.S. from August 2021 to April 2022 to participate in a cross-sectional survey of COVID-19 experiences and symptoms. Path analyses tested associations between COVID-19 experiences and symptoms, adjusting for sociodemographic and medical covariates.

Prevalent COVID-19 experiences included disrupted interactions with family and friends (66.0%), inability to perform daily routines (38.5%), and financial difficulties (18.5%). Greater financial hardship and disruptions to daily activities and social interactions were associated with higher levels of all physical and psychological symptoms. Endorsing more COVID-19 experiences (e.g., job loss, death of loved ones) was only associated with greater anxiety. Despite prevalent hardships, mean levels of physical and psychological symptoms were within normal ranges, except for elevated fatigue.

Although adverse COVID-19 experiences were common and related to symptom burden, patients with lung cancer showed notable psychological resilience during the pandemic. Oncology clinicians should consider the impact of COVID-19 experiences when providing financial and support services.

Holistic nursing care requires considering not only the physical and psychosocial but also the spiritual care needs of the patient.

This study aimed to determine the relationship between nurses’ perceptions of the concept of spiritual care and their attitudes towards death and the care of dying patients.

The sample of this descriptive and correlational study consisted of 383 nurses. Data were collected using the Spirituality and Spiritual Care Rating Scale (SSCRS), the Spiritual Support Perception Scale (SSPS), the Frommelt Attitude Toward Care of the Dying Scale (FATCOD), and the Death Attitude Profile Scale (DAP-R). The predictive role of nurses’ perceptions of spiritual care on their attitudes toward caregiving for patients approaching death and dying was examined using path analysis. The results of the analysis were presented as descriptive statistics (mean ± SD), and frequency (percentage) distributions. The reliability of the scales and subscales was examined using the Cronbach’s alpha internal consistency coefficient.

The path coefficient between the SSCRS and the DAP-R subscales of Fear of Death (β = 0.232; P = 0.025), Death Avoidance (β = 0.301; P = 0.007), Neutral Acceptance (β = 0.22; P = 0.01), Approach Acceptance (β = 0.444; P < 0.001), and Escape Acceptance (β = 0.659; P < 0.001) was statistically significant. The path coefficient between the FATCOD and the DAP-R subscales of Fear of Death (β = −0.032; P < 0.001), Death Avoidance (β = −0.038; P < 0.001), and Neutral Acceptance (β = 0.02; P < 0.001) was statistically significant.

It was determined that there was a correlation between the nurses’ perceptions of the concept of spiritual care and their attitudes towards death and the care of dying patients. It can be suggested that the nurses exhibited a more positive attitude toward the care of dying patients as their understanding of spirituality, spiritual support, and spiritual care increased.

People with serious illnesses often experience spiritual and emotional pain, manifesting in conditions such as depression, anxiety, and demoralization. Emerging research in psychedelic-assisted therapy has shown efficacy in treating these conditions. Despite evidence that psychedelics frequently occasion mystical/spiritual experiences in participants, there has been little research on support for spiritual, existential, religious, and theological needs, including the use of chaplains on therapeutic teams. Spiritual wellbeing outcomes have been inconsistently used and reported on in current psychedelics studies. The aims of this article are to identify and review patient-centered outcome measures focused on spiritual wellbeing for use in psychedelic research.

A literature review of instruments was conducted, with 286 articles included, identifying spiritual wellbeing measures within the palliative care population.

Three measures were selected for inclusion: Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12- Item Scale (FACIT-Sp-12), European Organization for Research and Treatment of Cancer Quality of Life Spiritual Well-being Questionnaire (EORTC QLQ-SWB-32), and the National Institutes of Health Healing Experience of All Life Stressors (NIH-HEALS). Instrument development, psychometric properties, and use in research for each are discussed.

Suitability in the context of psychedelic-assisted therapy with the palliative care population includes strong reliability and validity, and they should be accessible to people with various spiritual traditions, practices, and sources of connection. They should be patient-centered in their development, involve multiple stakeholders, and be appropriate for use with palliative care populations. According to these criteria and its orientation toward identifying spiritual change in the context of serious illness, the NIH-HEALS is recommended for wider use in psychedelic-assisted therapy.

To examine the relationships between patient activation, depressive symptoms, and quality of life among older adults receiving palliative oncology care.

A cross-sectional correlational study was conducted among 145 adults aged ≥60 years receiving palliative oncology care at King Khalid Hospital, Saudi Arabia, using stratified random sampling. Data were collected via a demographic and clinical questionnaire, the Patient Activation Measure-13 (PAM-13), the Patient Health Questionnaire-9 (PHQ-9), and the McGill Quality of Life Questionnaire–Revised (MQOL-R). Descriptive statistics, Pearson correlation, independent t-tests, one-way ANOVA, and multiple linear regression were performed using SPSS version 26.

All participants demonstrated Level 2 patient activation, with a mean PAM-13 score of 50.83 (SD = 1.04). Moderate depressive symptoms were prevalent (mean PHQ-9 = 13.56, SD = 3.48), and overall quality of life was moderate (mean MQOL-R = 55.21, SD = 10.14). Patient activation was weakly but significantly inversely correlated with depressive symptoms (r = −0.179, p < 0.05). No significant associations were found between patient activation and quality of life, or between depressive symptoms and quality of life. Regression analysis showed that patient activation, depressive symptoms, and demographics accounted for only 3.2% of the variance in quality of life (R2 = 0.032, p = 0.714).

Patient activation may modestly reduce depressive symptoms but is not sufficient to improve quality of life in older adults receiving palliative oncology care. Quality of life appears influenced by broader multidimensional factors beyond activation and mood, highlighting the need for comprehensive interventions in palliative care settings.

Psychedelic therapies are gaining attention as a novel therapy for existential distress in cancer patients. However, such treatments are often stigmatized and the views of support networks are unknown. Caregivers play an essential role in supporting the wellbeing and decision-making of people with cancer. In the context of a trial investigating psychedelic therapy for cancer patients, understanding the experience of the caregiver is important.

The objectives of this research were to investigate the hopes, beliefs, perceptions, and experience of caregivers for advanced cancer patients undergoing a trial investigating a psychedelic-assisted therapy.

Semi-structured interviews asked 15 caregivers about their experience at baseline and 1 month after their close associate had completed treatment in a feasibility trial where participants were randomized to receive either lysergic acid diethylamide (LSD) microdoses or placebo alongside meaning-centered psychotherapy (MCP). Blinded to condition, reflexive thematic analysis was used to analyze interview transcripts.

This study demonstrates the importance of bidirectional influences between caregiver and patient; the experience of one influences the experience of both. Caregivers were generally supportive of their close associate participating in a psychedelic-assisted trial, although some admitted hesitancy in them taking part. Caregivers described a desire to make the most of now, referring to the role of LSD microdose-assisted MCP as a means of accessing hope, improving the dyad relationship, and reducing existential distress.

Participation in trials investigating psychedelic-assisted MCP may offer hope for patients and their caregivers. Given the bidirectional relationship in wellbeing between cancer dyads, caregivers should be included alongside patients in such trials.

Amyotrophic lateral sclerosis (ALS) is a rare, progressive, and fatal disease that impacts the lives of affected individuals and their caregivers. Informal caregivers play a crucial role in supporting people with ALS (pwALS), yet they face major challenges. This study aims to analyze caregiver burden and health status among informal caregivers of pwALS in Portugal.

A cross-sectional survey-based study was conducted with adult informal caregivers of pwALS in Portugal, recruited through the Portuguese ALS patient association and healthcare professionals. Data included sociodemographics, caregiving activities, caregiver health (SF-36), patient functional status (ALSFRS-R), and caregiver burden (ZBI).

The study included 113 caregivers. Most were female (61.9%) and the partner (65.5%) or offspring (23.9%) of the pwALS. A quarter of caregivers received no social benefits. Mean ZBI was 32 ± 14.8, with most reporting mild to moderate burden. On the SF-36, general health was 51.1 ± 19.8, with mental health (55 [40; 70]) and vitality (43.8 [31.3; 56.3]) particularly impaired. ZBI scores correlated positively with caregiving hours (r = 0.274, p = 0.003) and negatively with ALSFRS-R (r = −0.411, p < 0.001). High burden caregivers exhibited poorer sleep quality (p =  0.026).

Caregivers experienced mild to moderate burden, with impaired mental health and vitality, but preserved physical functioning. A higher burden was linked with lower quality of life, poorer sleep, and greater patient disability. These findings underline the need for targeted education and training to support caregivers of pwALS.